MohdNor F H, Jamani N A, AbdAziz K H
Klinik Kesihatan Simpang Renggam, Jalan Rambutan Simpang Renggam Kluang Johor, Malaysia.
International Islamic University Malaysia, Kulliyyah of Medicine, Department of Family Medicine, Jalan Sultan Ahmad Shah, Kuantan Pahang Malaysia.
Med J Malaysia. 2025 Jul;80(4):508-520.
Current guidelines recommend that pregnant women engage in physical activity. Exercise during pregnancy has been shown to positively impact both maternal and fetal outcomes. Therefore, we conducted a systematic review to evaluate the impact of structured physical activity during pregnancy on maternal health and fetal outcomes.
A systematic search was conducted on relevant articles published between 2015 and 2020 using PubMed, Google Scholar, ScienceDirect, Scopus, and the Cochrane Library. Studies on pregnant women, comparative study designs with concurrent controls, structured physical intervention and health outcomes for both maternal and fetal were targeted. Maternal outcomes include gestational weight gain, lumbopelvic pain, gestational diabetes and preeclampsia, while fetal outcomes include prematurity and birth weight. Only original studies with published data were included. This review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta- Analysis.
A total of 3441 published articles were retrieved from different databases. After assessing the obtained papers, studies that did not meet the inclusion criteria were excluded. Twenty studies involving 5188 populations that met the inclusion criteria were included in this review. However, due to the heterogeneity of the studies, metaanalysis was not done. Structured physical activity significantly reduced the risk of gestational diabetes (OR: 0.57; 95% CI: 0.40-0.81; p = 0.002), but had no statistically significant effect on lumbopelvic pain (OR 0.98 (95% CI: 0.49 to 1.93) p=0.95), gestational weight gain (OR 0.88 95% CI: (0.44, 1.76) p=0.71), pre-eclampsia (OR 0.78, 95% CI: 0.41, 1.49, p=0.46) causing preterm delivery (OR 0.91, 95% CI (0.69, 1.20), p=0.50) or affecting fetal birth weight (mean difference 0.93, 95% CI (-42.67, 44.53), p=0.97) CONCLUSION: Structured physical activity during pregnancy, three times a week, 30 minutes per day of moderate intensity, is safe and benefits pregnant women and the fetus. Our findings challenge the view that physical exercise during pregnancy is not helpful and can be harmful. To generate further evidence, there is a need for high-quality, standardised trials that assess specific types of structured exercise program with better reporting of adherence and outcomes.
当前指南建议孕妇进行体育活动。孕期锻炼已被证明对母婴结局均有积极影响。因此，我们进行了一项系统评价，以评估孕期有组织的体育活动对孕产妇健康和胎儿结局的影响。
使用PubMed、谷歌学术、ScienceDirect、Scopus和Cochrane图书馆对2015年至2020年间发表的相关文章进行系统检索。目标是针对孕妇的研究、有同期对照的比较研究设计、有组织的体育干预以及母婴的健康结局。孕产妇结局包括孕期体重增加、腰骶部疼痛、妊娠期糖尿病和先兆子痫，而胎儿结局包括早产和出生体重。仅纳入有已发表数据的原始研究。本评价按照系统评价和Meta分析的首选报告项目进行报告。
从不同数据库共检索到3441篇已发表文章。在评估所获论文后，排除了不符合纳入标准的研究。本评价纳入了20项涉及5188名符合纳入标准人群的研究。然而，由于研究的异质性，未进行Meta分析。有组织的体育活动显著降低了妊娠期糖尿病的风险（OR：0.57；95%CI：0.40 - 0.81；p = 0.002），但对腰骶部疼痛（OR 0.98（95%CI：0.49至1.93）p = 0.95）、孕期体重增加（OR 0.88 95%CI：（0.44，1.76）p = 0.71）、先兆子痫（OR 0.78，95%CI：0.41，1.49 p = 0.46）导致早产（OR 0.91，95%CI（0.69，1.20），p = 0.50）或影响胎儿出生体重（平均差0.93，95%CI（-42.67，44.53），p = 0.97）均无统计学显著影响。结论：孕期每周三次、每次30分钟的中等强度有组织体育活动是安全的，对孕妇和胎儿有益。我们的研究结果挑战了孕期体育锻炼无益且可能有害的观点。为了产生更多证据，需要高质量、标准化的试验来评估特定类型的有组织锻炼计划，并更好地报告依从性和结局。
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